OP0150 LONG-TERM EFFECTIVENESS OF A LIFESTYLE PROGRAM FOR OSTEOARTHRITIS: ONE-YEAR FOLLOW-UP OF THE “PLANTS FOR JOINTS” RANDOMIZED CLINICAL TRIAL
Authors: C. Wagenaar, W. Walrabenstein, M. Van der Leeden, M. Gerritsen, J. Twisk, M. Van der Esch, H. Van Middendorp, P. Weijs, D. Van Schaardenburg
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The 16-week Plants for Joints (PFJ) multidisciplinary lifestyle program, based on a whole-food plant-based diet, physical activity, and stress management, significantly reduced The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score compared to usual care in patients with knee and/or hip osteoarthritis (OA) and metabolic syndrome.<sup>[1,2]</sup> <h3>Objectives</h3> To determine the long-term effectiveness of the PFJ program on pain, stiffness, and function in patients with OA. <h3>Methods</h3> In the PFJ randomized clinical trial, patients with knee and/or hip OA and metabolic syndrome were randomized to receive the PFJ program in addition to usual care, or the control group which received usual care. After this 16-week period the control group also received the PFJ program. After completion of the PFJ program all participants were followed-up for one year with biannual visits and 6 adherence-promoting webinars. Medication changes were assessed at one year as an "increase," "stable," or "decrease" compared to baseline. The primary outcome was pain, stiffness, and function assessed by the WOMAC. Secondary outcomes included anthropometric and metabolic markers. A paired sample T-Test was used to determine the significance of the difference in outcomes at the start of the intervention versus at 1-year follow-up. <h3>Results</h3> Of the 64 participants who completed the initial 16-week clinical trial 84% were female with a mean (SD) age of 63 (6) and body mass index of 33 (5) kg/m² at baseline. The 47 (73%) participants who completed the one-year follow-up had a slightly greater average change in WOMAC score (–11.4 vs. –11.0), weight (–5.3 vs. –3.7 kg), and CRP (–1.2 vs. –0.2 mg/l) compared to non-completers, but showed less improvement in HbA1c (–2.1 vs. –2.9 mmol/mol). After a decrease during the PFJ program, the WOMAC score increased slightly again in the year after the program, whereby a mean 8.8-point difference was still observed after one year for completed cases compared to baseline values (95% CI 13.6 to 4.0; <i>p</i> &lt; 0.01) (Figure 1). All components of the WOMAC remained significantly improved compared to before the program except for stiffness (Table 1). Of the 24 (38%) participants using pain medication at baseline, 11 (46%) were able to decrease the dosage or stop one or more medications. Pain medication was stable for 3 participants, and increased for 3, of which 1 newly started using medication. Furthermore, 3 (23%) and 8 (33%) participants decreased diabetes and cholesterol medication respectively while only 1 participant increased cholesterol medication. After the 1-year follow-up period weight and HbA1c remained significantly lower compared to baseline, although there was no longer a significant difference in CRP and LDL cholesterol. <h3>Conclusion</h3> The PFJ lifestyle program significantly decreased pain and improved function in patients with OA and metabolic syndrome and its effects were sustained until one year after program completion, with slightly less pain medication. Metabolic benefits found after the lifestyle intervention were partially sustained possibly indicating attenuated adherence to the lifestyle program in the 1-year follow-up. <h3>References</h3> [1] Walrabenstein, Trials 2021 [2] Walrabenstein, EULAR 2022 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Carlijn Wagenaar: None declared, Wendy Walrabenstein: None declared, Marike van der Leeden: None declared, Martijn Gerritsen Grant/research support from: Received funding for research from Horizon Therapeutics., Jos Twisk: None declared, Martin van der Esch: None declared, Henriët van Middendorp: None declared, Peter Weijs: None declared, Dirkjan van Schaardenburg: None declared.